Bill would ensure autism treatments are covered

Feb. 18, 2014

Written by

About the bill

NUMBER: House Bill 1257 WHAT IT DOES: Require insurance companies to cover treatment for autism spectrum disorders WHY IT’S PROPOSED: Mental health treatments for children with autism spectrum disorders can be pricey — and sometimes insurance companies don’t like to pay for them. HEARING: 7:45 a.m. today, House Health and Human Services Committee. LISTEN: at www.sdpb.sd.gov/player/412.html. READ THE BILL: at legis.sd.gov/docs/legsession/2014/Bills/HB1257P.pdf

More

ADVERTISEMENT

Brookings mother Michelle Powers told lawmakers last week that a treatment known as applied behavior analysis, or ABA, had helped her daughter make leaps and bounds in only seven months.

“She’s able to cope with her world more easily,” Powers said. “It’s because of these therapies that we have hope. But now, our insurance company, which has provided very good coverage for her therapies for seven months, has informed us that they would no longer cover these therapies.”

Powers said her family can’t afford that therapy, and worked with Brookings Rep. Scott Munsterman to introduce legislation that would require insurance companies to cover treatment for autism spectrum disorders. A range of parents and doctors testified last week that the reform is the right thing to do.

“Her doctors recommended these therapies as medically necessary. Yet my insurance company has the ability to make an arbitrary decision to discontinue these therapies that are necessary for my daughter. And I have no recourse,” Powers said.

But insurance companies oppose the bill, viewing it as a new mandate that would restrict their ability to do business. They also criticized the measure as overly broad — it doesn’t just single out the ABA therapy that many parents focused on last week in testimony.

The state Department of Labor and Regulation said the bill could be costly to the state. Because of provisions in the federal Affordable Care Act, states can’t easily pass on new requirements to health insurance companies. Instead, Melissa Klemann of the department testified, taxpayers could be on the hook for more than $400,000 per year.

While supporters noted that dozens of other states have made similar requirements, Klemann said many of them had acted before the Affordable Care Act’s limitations took effect and thus weren’t subject to those costs.

The measure drew almost two hours of testimony and probably will be decided this morning.